It is simplistic in appearance. Many may say that it is even naïve. Yet "hidden" in the simplicity may be just what you were looking for: a low stress, high return approach to marketing. It is a chance to build a practice that is consistent and dependable in an economy that is anything but.

On the surface, marketing is far more art than science. I have read—and continue to read—the bestselling marketing books that crop up each year. I do it because I, probably much like you, want to know the "answer" or the "solution". In spite of my chiropractic beliefs, I still find myself looking for the magic pill. Yet, too often, I read books back-to-back, each written by an expert with impressive credentials, each story told with unshakable confidence, and each completely contradicts the other. Direct mail is in. Direct mail is out. Telemarketing is in. Telemarketing is out. Big yellow page ad in. Big yellow page ad out.

Whenever I get hit with these opposing "truths", I am haunted with echoes in the recesses of my brain—areas not touched since college economics: "This is true as long as everything else remains the same." The reality is this: Nothing remains the same. What works in Atlanta may not work in Albuquerque. What works in Davenport may not work in Denver. What works in Timbuktu may not work in your neighborhood. And that is just looking at geographic differences. What about demographics? What about technique? What about socioeconomic differences? Listen to the experts, if you want. I do. They have great ideas. But keep this in mind: It is not the art of marketing that is efficient or successful. It is the science. And how does this relate in any way to chiropractic software? I’m glad you asked.

For years and years advertising was the king of the marketing hill. You spent money. You waited for new business. You spent money. And waited for business. The problem was—and is—trying to determine how effectively you spent your marketing dollars. Direct marketing—either by mail or phone—was the answer to many peoples’ marketing prayers, because it gave a direct and measurable return. The value here is having the ability to test different approaches. People are fickle. People are finicky. Try what you think will work…and measure to see if it does. It is in this process that you will quickly discover where to spend your marketing dollars...and where you are just wasting your money. Repeat what works. Discard what fails. The challenge that most chiropractors have is collecting accurate numbers with which to make these decisions. So, before you drop next year’s Annual City [fill in community event of choice] Screening, make sure you are looking at the proper numbers. It’s easy to keep track of how much you spend and how many new patients it generated, but is that really the whole picture?

Lets say you are trying to prepare a marketing budget for next year. You sit down with all the numbers to figure out what worked and what didn’t over the course of the year. You see that Spinal Screening A cost $450, generated 9 new patients, and you ultimately collected $6000. Looking at Spinal Screening B you see that it also cost $450, but it only generated 2 new patients and $1800. If forced to choose one screening over the other, the logical choice with the available data appears to be Screening A. But, again, is that the whole picture?

Patient referrals should play a tremendous role in the growth and health of your business. Yet, how many offices take them into consideration when analyzing the return on investment of their marketing efforts? Let’s take the previous example. What if the two people from Screening B were business owners, or community leaders, or medical doctors, or attorneys? What if those two referred five, and those five referred twenty-three, and so on and so forth? Looking below the surface and including the money collected from the referred patients, we may find that Screening B ultimately brought in $30,000 or $40,000. Trying to judge one marketing effort from another without all of the facts can be a costly mistake. This is where most office systems fail; they don’t report patient referral information completely. This leaves you to make business decisions without some of the most critical information about your practice: The complete effects of patient referrals.

Though the task of collecting this information may seem daunting, a software tool called the Cascading Referral Analysis™ has recently become available to do it for you. It allows doctors to calculate their Return on Investment (ROI) on any marketing effort—including patient referrals resulting from that source. The Cascading Referral Analysis™ gives you the exact number of patients and the collected dollar amounts for each event, plus those generated by their referrals. You can also look at that information per patient. If you are a visual thinker, you can even see the connections on screen and step through them one at a time. This detailed information is not only fun or interesting to look at; it can be critical in allocating your marketing dollars.

The science of marketing can be a powerful tool. Yet there is one component to the Cascading Referral Analysis™ that falls more into the mystical art side of the marketing equation. B. J. Palmer stated that, "You never know how far reaching something you may think, say, or do today will effect the lives of millions tomorrow." With a tool like this, you can demonstrate for your existing patients how important it is to refer other people. It is a powerful thing to actually see the far-reaching effect…to know that referring one person was the catalyst that cascaded into a group of twenty or thirty people. Maybe next time they think about sharing the chiropractic story, they will realize that the health and well being of many others is counting on them as well.

David and DeDe Van Riper of InPhase Technologies Group have worked in the chiropractic profession at many levels for more than a decade. InPhase Technologies Group is a company dedicated to providing a comprehensive approach to chiropractic office systems.

For more information contact
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or 800-490-3780.

Remember the good old days, when you used to plug your mouse into a serial port on the back of your computer, and IT DID NOT WORK? And when you finally loaded the right driver, you were SO HAPPY that it worked? And then you got REAL techno-geekish, and purchased a PDA (Palm Pilot) and/or digital camera and you REALLY found out how difficult serial ports were, since your PDA required the same serial port used by your mouse? Well, those days are over and so is the serial port. The serial port is rapidly going the way of the rotary dial phone, and is being replaced by the USB (Universal Serial Bus) port. What is really cool is that one USB port is capable of supporting many devices simultaneously, making it perfect for the technologically advanced doctors office.

Now here is the bad news: Virtually all chiropractic electronics devices (instrumentation including Range of Motion, Muscle Testing, SEMG and Thermography) utilize the serial port, leaving you totally stranded if you opt to purchase a newer computer (especially the lower cost computers). Serial ports still exist, but they are disappearing fast, so it is time to find a techno-solution.

A little background first: There are basically three ways to connect peripheral devices (such as cameras, chiropractic instrumentation, scanners etc.) to your computer: The serial port, USB port, and Firewire (also known as IEE1394) port. Some rare nut cases actually try to use the infrared ports, but anyone who has tried has found out how difficult that can be. There is also Bluetooth (which is a wireless standard), but it is not functional enough at this point to discuss. Parallel ports are disappearing along with serial ports.

USB is broken into USB 1.1 (low speed, used with mice or printers), and USB 2.0 (high speed, as is used with external hard drives and CD burners). USB 2.0 is rapidly becoming standard on new computers. Firewire (IEEE 1394) runs at about the same speed as USB 2.0, but is used mainly in digital video cameras and some hard drives only.

With chiropractic instrumentation typically outliving computers by many years, when you go to upgrade your computer, you’ll find that you simply cannot connect your instrumentation to your computer, leaving you without the essential instrumentation and clinical data every modern office relies upon.

How do you interface that ROM device, Muscle Tester, SEMG and Thermography devices to you computer when there are no serial ports?

One solution is to purchase "off the shelf" serial to USB converters for each of your serial devices. The problem is that they are typically "general purpose" converters, and are not designed to function with your specific instruments. I have found that they work around 80% of the time, which may be acceptable for some people.

As one who is easily frustrated, I gave up, and decided to design my own serial to USB converter. Customizing it to our specific needs provides significantly greater reliability. In addition, it is backwards compatible with all of our instruments going back to approximately 1991, and is truly "Plug & Play" on most operating systems, meaning there is little or no setup required.

The advantage of this solution is so great that, prior to purchasing ANY equipment in the next year, you should make certain that it is "designed for USB". Note that marketing people are great at twisting the facts, and will try to claim that off-the-shelf USB to serial converters are built for their devices; so buyer beware, and ask several questions prior to purchasing any instrumentation any time in the future.

Questions to ask to determine if the product you are interested in is truly USB compatible:

1. Does the device function or have a connection which works on a serial port? If the answer is, "Yes," then you know that the device is a serial device, and the next few questions are very important ones.

2. Will it function on a USB port at all? If the answer is, "No," be aware that you may have trouble connecting it to your computer, or a computer you purchase in the future. If the answer is, "Yes," ask the following question:

3. Does it use a serial to USB converter? If the answer is, "Yes," ask:

4. Does it use an "off the shelf" converter, such as a brand name model, which can be purchased online, or from a computer store? (Some brand names include Belkin, Keyspan, and Radio Shack) If the answer is, "Yes," you may experience more difficulty with the product.

5. Is the product designed to be used with USB without an off-the-shelf converter? If the answer is, "Yes," this is the product you will most likely be happiest with.

Not only will the purchase of a product designed for USB be more reliable, easier to use, and protect your investment by interfacing to computers you may upgrade to in the future, but you can also purchase a less expensive computer. To put it into perspective, Dell now sells a notebook computer for $799.00 without a serial port. The least expensive model with a serial port costs $1199.00. What they are trying to communicate is, "We are getting rid of serial ports, so listen up!"

Technology can be your best friend or worst enemy. By finding the best product and support for your needs, you will have a great partner in building your practice.

The author, David Marcarian, MA, is founder and president of Precision Biometrics, supplier of the MyoVision SEMG and Thermoglide systems. He has worked for NASA, and was awarded a $450,000 grant from the NIH for developing the MyoVision. He lectures for Palmer College of Chiropractic and his course is endorsed by all U.S. chiropractic associations that mandate SEMG training. He has personally instructed more than 6,000 chiropractors on proper SEMG use. Mr. Marcarian can be reached at 800-969-6961, by email at
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, or visit his company’swebsite at www.myovision.com.

Visiting the Seattle Boat Show recently, I was amazed to find a perfectly located and great looking booth, with energetic DC’s chomping at the bit to sign up new patients. They were literally following people as they walked by, but everyone kept on walking. I said to the doctor in charge, “Why would you spend all this money on this show, and not be using a Static SEMG?” Although he had never used one, he had no trouble listing a million reasons why it was a waste of time. I suggested we try it for an hour just for grins. He begrudgingly agreed. Needless to say, with the SEMG setup, potential new patients were literally lining up to be tested. One screener said, “Wow! I can’t believe they are actually coming to us.” After an hour, I was getting bored, so I packed it up when he wasn’t looking and left. I did not even make it to my car before my cell phone started ringing. It was the doctor, of course. “Where did you go?” he said. “You told me it was a waste of time to use an SEMG, so I left,” I responded. “No, No, No…. Please, bring it back!” he said. What made the huge difference? Technology. Our society eats, breathes, and believes in technology. We don’t trust it unless it has been “blessed” by a computer of some sort. Add to this the fact that 80% of us are visual learners, and it is obvious. Doctors report a five- to ten-fold increase in number of new patients when using instrumentation in comparison to traditional screenings, and agree that the machines are paid for in their first couple of screenings1.Instrumentation: Static Surface EMG (approximately $5000): Why? SEMG’s can be used in all environments, regardless of temperature (unlike thermography), and people naturally understand muscle tension, making it simple to explain. Since they can feel it, you establish credibility with them very quickly. What characteristics make an SEMG optimal for screenings? a. The lighter the weight, the better. Every piece of equipment, including the SEMG, should be as light as possible. A solid, easy-to-use transport case is a nice option, but is not totally necessary. b. Standing Neutral SEMG tests are optimal for screenings. i. Load bearing, “chiropractically” sound standing tests bring out more abnormalities, and you don’t have to lug a couple of chairs with you. ii. You are more visible than when doing seated tests, as you are at or above eye level when testing. iii.Psychologically, people associate the seated position with making a commitment, as with purchasing a car. People are much more likely to allow you to test them standing, as they feel less threatened. c. Software should be simple to use, fast and should not require that you enter patient names (both for speed and HIPAA). Systems that use Function keys instead of the mouse allow you to test in sunlight where the screen is less visible. This is particularly important in spring and summer screenings, which are often outdoors. d. Graphics should be clean, simple and are much more powerful if presenting a sample “ideal” test alongside the results, for comparison purposes. e. Voice prompts and/or sound is very important, as the more senses appealed to, the more people you will attract. 2. MONITOR: Price: $180 to $3000. Best value: 19” Color Monitor. Most “Punch”: Data Projector or Plasma Screen. a. Considering that 19” monitors are under $180, it makes more sense to use a monitor than a TV. If you can afford an LCD, purchase at least a 17” screen. 42” Plasma screens are great, but cost upwards of $3000. b. If you can afford a data projector, they are very powerful when used indoors. (Must be at least 1000 lumens, and 800 x 600 resolution). The best projector screen is the Dalite Instatheater 60” (around $350). The screen rolls itself into a solid carry case, and looks like an expensive big screen TV when setup. 3. SPEAKERS: $20 to $40. Labtec “Spin” series computer speakers are inexpensive, small and work well. 4. MONITOR RISER: Fellowes Premium Monitor Riser (model 91717, approx. $22) allows you to place the monitor on top of the SEMG, not only making the monitor more visible, but saving space.5. POWER: AC when available (call ahead to secure it). The next best thing is a deep cycle marine battery (120 amp hours) with a 400-watt power inverter (available from West Marine, or auto parts stores). You will also need a part from Radio Shack which provides a cigarette lighter adapter wired to red and black alligator clips (to connect to the battery). Plug the inverter into the cigarette lighter adapter, and you have power! Don’t forget, you need a charger for this. Honda 1000 watt generators are also good, but ONLY if you can place them far enough from your screening to avoid the obvious noise problems. 6. PRINTER: I am very impressed with the new HP 450ci printer ($299). It is fast, rugged, and small. Set it to draft mode for the greatest speed.

Instrumentation makes screenings not only more efficient and effective but, also, more fun. Don’t forget to have a positive attitude, and remind each potential patient that results are not as accurate as they would be in the clinic. This not only is the truth but, also, provides motivation for them to visit your office for a complete exam. Technology can be your best friend or worst enemy. By finding the best product and support for your needs, you will have a great partner in building your practice. TAC

The author, David Marcarian, MA, is founder and president of Precision Biometrics, supplier of the MyoVision SEMG and Thermoglide systems. He has worked for NASA, and was awarded a $450,000 grant from the NIH for developing the MyoVision. He lectures for Palmer College of Chiropractic, and his course is endorsed by all U.S. chiropractic associations that mandate SEMG training. He has personally instructed more than 6,000 chiropractors on proper SEMG use. Mr. Marcarian can be reached at 800-969-6961, by email at
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
, or visit his company’s Web site at www.myovision.com.

OK, so I’m powering by Bill Gates’ house in my boat (no joke, he’s right there on Lake Washington), and thinking, “Wouldn’t it be fun to do to Bill what Tony Soprano did to his new lawyer-neighbor in the last episode of “The Sopranos? Set my sport yacht right there in front of his house, with speakers blasting—but, instead of Frank Sinatra, pipe in the nasty tech support calls which come into Microsoft over it’s most recent ‘new and improved’ software?” So we have the topic of my January 2003 set of “David’s Rules”. Remember, the key is to live a stress-free partnership with technology. That means OUTSMARTING it. “Preemptive Strike” is the key phrase. Get it before it gets you.

New Strategy for 2003: Instead of buying your new computer, or upgrading your current computer with a software CD, and finding out the hard way that there are problems with the operating system itself, do the following BEFORE you install any new application software or peripheral devices:

Preemptive strike with Brand New Computer setup or upgrade to Windows XP: Contact Technical support or the website for a new product you plan to install. Find out what changes have occurred with your software installation, and follow the new instructions, if there are any on the website. In other words, take a few moments to check out the website for last minute changes in the installation process, which may not have been documented in the installation software.

XP is notorious for having multitudes of little gremlins running around your machine from the day you get it. Thanks to the internet, Microsoft now provides automatic updates to your system which should “kill” as many of those gremlins as possible. These days, the FIRST thing you should do when purchasing a new computer, or upgrading your computer to XP is to perform a “windows update” immediately after the upgrade or setup finishes. It is relatively simple:- Setup your new computer or upgrade to XP. - Get online.- Go to Start, Help & Support, Pick a Task, Windows Update. Follow the relatively simple instructions, and your system will actually “heal itself”. Be aware that it could take up to several hours, so plan for this. Your input is not required for most of the process, but you should be around, just in case the computer needs a decision from you.

Preemptive Strike with installation of new software applications: Most software manufacturers get a huge discount for creating a huge number of software CD’s at once, so the software on your CD may be months old. RULE: The Software CD in your hand is an illusion. The real software is sitting on a website somewhere for you to download. When installing software, first, download the most recent upgrade from the software company’s website. Next, install the software CD. Then, install the update you downloaded. Reboot your computer, and now you have the latest software prior to working with it and finding out there are serious bugs.

I just installed ACT 6.0 on my system. Believe it or not, the instructions on their website are totally different than the software’s own installation program would suggest. If there had not been technical support there to help, the program would never have worked. Note that I waited for them to release a software “fix” on their website prior to purchasing the upgrade. I wanted the other less suspicious (and probably less experienced) users to experience the pain required for the new update, first. I find this so unacceptable that all software produced by my company is beta tested for months prior to releasing it. The new release of the our 2k3 software is in its 36th revision PRIOR to being released. Most marketing companies ship products and THEN figure out how to get them to work. Engineering companies like ours, create thoroughly tested products and THEN ship to customers. I’ve noticed that doctors who become more technologically savvy almost always choose products with great engineering over the ones with slick advertising.

Windows 98 Essential Technical Tips:

If still using Windows 98, make certain to reboot the system once daily, as there are problems with Windows 98 machines getting “messed up” from sitting too long. If you even noticed Windows 98 getting unstable, this is the most common cause.

Backup up the system entirely once yearly, and run the computer’s recovery CD (if you have it) once per year to restore Windows 98 to its optimal working order. Windows 95/98 has a tendency to develop something similar to arthritis over time, and the only true fix is to restore to original setup, and re-install your software applications yearly. If you start having trouble with the system crashing, this is the time to perform the recovery. The hardest part is reinstalling your software applications, so make sure you have them all, prior to this process.

Technology can be your best friend or worst enemy. By finding the best product and support for your needs, you will have a great partner in building your practice. Follow the simple guidelines above, and you will enjoy all, the advantages of technology without the stress. TAC

The author, David Marcarian, MA, is founder and president of Precision Biometrics, supplier of the MyoVision SEMG and Thermoglide systems. He has worked for NASA, and was awarded a $450,000 grant from the NIH for developing the MyoVision. He lectures for Palmer College of Chiropractic and his course is endorsed by all U.S. chiropractic associations that mandate SEMG training. He has personally instructed more than 6,000 chiropractors on proper SEMG use. Mr. Marcarian can be reached at 800-969-6961 and via email at:
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
, or visit his company’s website at www.myovision.com.

I’ll admit it. I’m a techno-geek. I have internet access on my Pocket PC, two cell phones, four notebook computers, internet access on my boat, and anyone who has asked me to solve a computer problem knows that I know what I am doing. I love technology; and, just like your passion is the spine, my passion, and the passion of my company is to keep ahead of the technology curve, so you do not have to. With twenty-one years’ experience in the “Silicon Valley”, including research at NASA and IBM’s ergonomics labs, I have learned quite a bit about technology and making it easy for people to use, e.g., people like doctors, who need to spend time with patients, not fixing computers.

If you want to utilize technology in the most stress-free manner, here are “David’s Rules”:

Never purchase any technology unless it has been around for at least six months. The reason IBM is rated the highest in reliability is because they do not release technology until others have worked the bugs out first. I believe in this philosophy fully, and it shows in my product designs.

Always purchase “name brand” computer hardware. There is a significant difference in reliability with an IBM, Dell or Gateway, as compared to a “clone” which was custom built with all the quirks that brings.

Purchase high quality printers and displays. The public is more likely to be drawn to a doctor that is higher tech. There is nothing worse than doing a screening with a slow printer.

If upgrading from Windows 98 to Windows 2000 or XP, have a professional do the installation. You may never figure out how to get it to work properly.

Purchase quality backup hardware (tape drive, or backup drive). Use five backup disks (media), one for each day of the workweek. Take the tapes off site daily in case of fire or theft.

When evaluating which chiropractic software and hardware/instrumentation products, always ask technologically savvy friends in your profession, who own AND USE a technology you are interested in, the following questions:

Does the software crash? How often does it crash? If Tech. Support has not been able to resolve crashes, avoid the product.

Is the instrument reproducible? Have a "well-trained" friend perform two tests in a row. Print them out for an objective comparison, if the software does not do overlays. Don’t worry about hurting the feelings of the owner. If the product is not reproducible, this will affect your credibility with your patients and your community.

How reliable is the product? How often has it required repair? How is the technical support? Having a great concept for a product is great, but avoid products that have poor reliability or technical support.

Do you have to purchase specialized supplies from the manufacturer? If the supplies are available from multiple suppliers, it means cost savings for you.

Is the software fast, easy to use, and simple? Simplicity is the hallmark of a great product.

Is your machine capable of performing the types of test you need? For example, if the cervical spine is of interest to you, make certain your machine is capable of doing a complete cervical measure. If you are interested in Standing Neutral SEMG tests to correlate with your X-ray, and follow in the tradition of chiropractic itself, find a product which uses a button press on the probe. The button press is optimal, as it allows you to stand in a neutral posture when testing. If possible, test a system prior to purchasing it.

Does the technical support include the ability to remotely access your computer, via modem, for problem resolution? It is the next best thing to having a technician right in your office, and a service you won’t want to live without once you experience it.

What are the details of the warranty? Get the warranty statement in writing so you can see the limitations. If, for instance, you get a three-year warranty, does it include all components? Less comprehensive warranties may cost you thousands in repairs.

Technology can be your best friend or worst enemy. By finding the best product and support for your needs, you will have a great partner in building your practice. Follow the simple guidelines above, and you will enjoy all the advantages of technology without the stress. TAC

The author, David Marcarian, MA, is founder and president of Precision Biometrics, supplier of the MyoVision SEMG and Thermoglide systems. He has worked for NASA, and was awarded a $450,000.00 grant from the NIH for developing the MyoVision. He lectures for Palmer College of Chiropractic and his course is endorsed by all U.S. chiropractic associations that mandate SEMG training. He has personally instructed more than 6,000 chiropractors on proper SEMG use. Mr. Marcarian can be reached at 800-969-6961 and via email at:
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
, or visit his company’s website at www.myovision.com.